Critical Care & Anaesthesia- June 2012

 

 

Critical Care & Anaesthesia – Update  

 

 


June 2012

Welcome to the June bulletin of 2012 highlighting new evidence published on selected topics relating to Critical Care, Anaesthesia, Pain and Resuscitation. This bulletin will continue in its current format following a positive evaluation by staff. Full text articles can be accessed via your HEFT Athens ID.

Anaesthesia

The following sub-topics are covered:

  • Cell salvage in surgery (including obstetric surgery)
  • Anaesthesia and surgical outcomes (including epidurals, regional anaesthesia)
  • Anaesthesia and Immunomodulation
  • Anaesthesia and post operative confusion

 

Title: Cost analysis of cell salvage in pediatric surgery

Citation: Value in Health, June 2012, vol./is. 15/4(A75-A76), 1098-3015 (June 2012)

Author(s): Samnaliev M., Tran C., Gasior I., Sloan S.R., Lightdale J., Brustowicz R.

Abstract: The objective of the study was to compare the societal costs associated with four transfusion strategies among patients undergoing elective orthopedic or cardiac surgery in Children's Hospital Boston: 1) CS followed by autologous transfusion; 2) CS followed by allogeneic transfusion; 3) autologous transfusion alone; and 4) allogeneic transfusion alone.


 

Title: Is there an increased risk of tumor recurrence when intraoperative blood salvage autotransfusion used for liver transplantation in patients with hepatocellular carcinoma?

Citation: Liver Transplantation, May 2012, vol./is. 18/(S105), 1527-6465 (May 2012)

Author(s): Akbulut S., Kayaalp C., Yilmaz M., Ozgor D., Karabulut K., Eris C., Toprak H.I.

Abstract: The aim of this study was to evaluate the risk of tumor recurrence in patients with HCC who used Intraoperative blood salvage autotransfusion (IBSA) during LT.


 

Title: Impact of cell salvage during cardiac surgery on the thrombelastomeric coagulation profile: A pilot study

Citation: Perfusion, May 2012, vol./is. 27/3(221-224), 0267-6591;1477-111X (May 2012) Author(s): Campbell J., Holland C., Richens D., Skinner H.

Abstract: This is a report of a randomised control trial of 20 patients undergoing coronary bypass surgery. Residual cardiopulmonary bypass volume was processed and transfused after surgery in the cell salvage group and the residual volume was transfused unprocessed in the control group. The coagulation profile was measured using the Rotem thrombelastometry system.

Full Text: Available in fulltext at EBSCOhost Available in fulltext at ProQuest

Title: Are antifibrinolytics helpful in decreasing blood loss and transfusions during spinal fusion surgery in children with cerebral palsy scoliosis?

Citation: Spine, April 2012, vol./is. 37/9(E549-E555), 0362-2436;1528-1159 (20 Apr 2012) Author(s): Dhawale A.A., Shah S.A., Sponseller P.D., Bastrom T., Neiss G., Yorgova P., Newton P.O., Yaszay B., Abel M.F., Shufflebarger H., Gabos P.G., Dabney K.W., Miller F.

Abstract: The objective was to evaluate the safety and efficacy of antifibrinolytic (AF) agents in reducing blood loss and transfusions during posterior spinal fusion (PSF) in children with cerebral palsy (CP) scoliosis.


 

Title: Two different dosing regimens of human recombinant erythropoietin beta during preoperative autologous blood donation in patients having hip arthroplasty

Citation: International Orthopaedics, April 2012, vol./is. 36/4(703-709), 0341-2695;1432-5195 (April 2012) Author(s): Buljan M., Nemet D., Golubic-Cepulic B., Bicanic G., Tripkovic B., Delimar D.

Abstract: Aim was to evaluate the effectiveness of two different dosing regimens of human recombinant erythropoietin (rHu-EPO) for preoperative autologous blood collection in patients undergoing total hip arthroplasty (THA).


 

Title: Spinal anesthesia for noncardiac surgery in infants with congenital heart diseases

Citation: Paediatric Anaesthesia, July 2012, vol./is. 22/7(647-653), 1155-5645;1460-9592 (July 2012) Author(s): Kachko L., Birk E., Simhi E., Tzeitlin E., Freud E., Katz J.

Abstract: The objective of the study is to compare hemodynamic parameters in infants with congenital heart disease (CHD) undergoing noncardiac surgery (NCS) under awake spinal anesthesia (SA) with controls without CHD also undergoing SA.

Full Text:  Available in fulltext at EBSCOhost


 

Title: Effect of pre-exposure to sevoflurane on the bispectral index in women undergoing Caesarean delivery under general anaesthesia

Citation: British Journal of Anaesthesia, June 2012, vol./is. 108/6(990-997), 0007-0912;1471-6771 (June 2012) Author(s): Choi W.J., Kim S.H., Koh W.U., Hwang D.I., Cho S.K., Park P.H., Han S.M., Shin J.W.

Abstract: The study assessed the effects of pre-exposure to sevoflurane on the bispectral index (BIS) in the interval before delivery.

Full Text: Available in fulltext at EBSCOhost EJS Available in print at Solihull Staff Library


 

Title: Multimodal periarticular injection vs continuous femoral nerve block after total knee arthroplasty. A prospective, crossover, randomized clinical trial

Citation: Journal of Arthroplasty, June 2012, vol./is. 27/6(1234-1238), 0883-5403;1532-8406 (June 2012) Author(s): Ng F.-Y., Ng J.K.F., Chiu K.-Y., Yan C.-H., Chan C.-W.

Abstract: This study compares the efficacy of pain control using continuous femoral nerve block (FNB) and multimodal periarticular soft tissue injection. This is a randomized, crossover, clinical trial.


 

 

Title: Anesthetic management in patients undergoing hyperthermic chemotherapy

Citation: Current Opinion in Anaesthesiology, June 2012, vol./is. 25/3(348-355), 0952-7907;1473-6500 (June 2012) Author(s): Raspe C., Piso P., Wiesenack C., Bucher M.

Abstract: Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has become an important therapeutic option for selected patients with peritoneal surface malignancies. This aggressive multimodality treatment is complex, not only regarding surgical technique, but also regarding anesthesia. The present review represents the author’s experience in anesthetic care.


 

Title: Arytenoid adduction combined with medialization laryngoplasty under general anesthesia using a laryngeal mask airway

Citation: American Journal of Otolaryngology - Head and Neck Medicine and Surgery, May 2012, vol./is. 33/3(303-307), 0196-0709;1532-818X (May-June 2012)

Author(s): Kanazawa T., Watanabe Y., Hara M., Shinnabe A., Kusaka G., Murayama T., Iino Y.

Abstract: To develop a new procedure for patients undergoing Laryngeal framework surgery, the authors we evaluated voice outcomes after arytenoid adduction combined with medialization laryngoplasty under general anesthesia using a laryngeal mask airway (LMA) for unilateral vocal cord paralysis.


 

Title: Impact of anterior scalene lidocaine blocks on predicting surgical success in older patients with neurogenic thoracic outlet syndrome

Citation: Journal of Vascular Surgery, May 2012, vol./is. 55/5(1370-1375), 0741-5214;1097-6809 (May 2012) Author(s): Lum Y.W., Brooke B.S., Likes K., Modi M., Grunebach H., Christo P.J., Freischlag J.A.

Abstract: Surgical management of neurogenic thoracic outlet syndrome (NTOS) is controversial due to the lack of predictors of success and difficulties in patient selection. The study sought to examine the effects of patient demographics, etiology, duration of symptoms, and the selective use of lidocaine and botulinum toxin anterior scalene blocks on outcomes of patients undergoing transaxillary decompression with first rib resection and scalenotomy for NTOS.

Full Text: Available in fulltext at Ovid


 

Title: Effect of intraoperative lidocaine on anesthetic consumption, and bowel function, pain intensity, analgesic consumption and hospital stay after breast surgery

Citation: Korean Journal of Anesthesiology, May 2012, vol./is. 62/5(429-434), 2005-6419;2005-7563 (May 2012) Author(s): Choi S.J., Kim M.H., Jeong H.Y., Lee J.J.

Abstract: The study investigated whether intraoperative lidocaine infusion reduced anesthetic consumption, duration of ileus, pain intensity, analgesic consumption and hospital stay after breast plastic surgeries.

Full Text: Available in fulltext at National Library of Medicine


 

 

 

Title: Spinal analgesia for laparoscopic colonic resection using an enhanced recovery after surgery programme: Better analgesia, but no benefits on postoperative recovery: A randomized controlled trial

Citation: British Journal of Anaesthesia, May 2012, vol./is. 108/5(850-856), 0007-0912;1471-6771 (May 2012) Author(s): Wongyingsinn M., Baldini G., Stein B., Charlebois P., Liberman S., Carli F.

Abstract: This study was undertaken to determine the impact of an intrathecal mixture of bupivacaine and morphine, when compared with systemic morphine, on the quality of postoperative analgesia and other outcomes in the context of the enhanced recovery after surgery (ERAS) programme for laparoscopic colonic resection.

Full Text: Available in fulltext at EBSCOhost EJS Available in print at Solihull Staff Library


 

Title: Subpleural block is less effective than thoracic epidural analgesia for post-thoracotomy pain: A randomised controlled study

Citation: European Journal of Anaesthesiology, April 2012, vol./is. 29/4(186-191), 0265-0215;1365-2346 (April 2012) Author(s): Kanazi G.E., Ayoub C.M., Aouad M., Abdallah F., Sfeir P.M., Adham A.-B.F., El-Khatib M.F.

Abstract: The study aims to compare subpleural analgesia with thoracic epidural analgesia in patients undergoing thoracotomy.


 

Cardiac arrests/cardiopulmonary resuscitation (CPR)

The following sub-topics are covered:

  • Quality of CPR
  • Use of feedback devices
  • Leadership and team factors

 

Title: CPR and postarrest care: overview, documentation, and databases.

Citation: Chest, April 2012, vol./is. 141/4(1082-9), 0012-3692;1931-3543 (2012 Apr)

Author(s): Gaieski DF, Abella BS, Goyal M

Full Text: Available in fulltext at MD Consult; Note: You will need to register (free of charge) with MD Consult the first time you use it.


 

Title: Resuscitation highlights in 2011.

Citation: Resuscitation, January 2012, vol./is. 83/1(1-6), 0300-9572;1873-1570 (2012 Jan) Author(s): Nolan JP, Ornato JP, Parr MJ, Perkins GD, Soar J

Full Text: Available in fulltext at Elsevier; Note: You will need to register (free of charge) with Science Direct the first time you use it.


 

Title: Motion detection technology as a tool for cardiopulmonary resuscitation (CPR) quality improvement.

Citation: Resuscitation, January 2012, vol./is. 83/1(e11-2), 0300-9572;1873-1570 (2012 Jan) Author(s): Semeraro F, Marchetti L, Frisoli A, Cerchiari EL, Perkins GD

Full Text: Available in fulltext at Elsevier; Note: You will need to register (free of charge) with Science Direct the first time you use it.


 

 

 

Title: Quality controlled manual chest compressions and cerebral oxygenation during in-hospital cardiac arrest.

Citation: Resuscitation, January 2012, vol./is. 83/1(138-42), 0300-9572;1873-1570 (2012 Jan) Author(s): Kamarainen A, Sainio M, Olkkola KT, Huhtala H, Tenhunen J, Hoppu S

Abstract: In this descriptive study the authors aimed to evaluate whether the quality of feedback-monitored CPR during in-hospital cardiac arrest is reflected in near infrared frontal cerebral spectroscopy (NIRS).

Full Text: Available in fulltext at Elsevier; Note: You will need to register (free of charge) with Science Direct the first time you use it.


 

Title: Effect of feedback on delaying deterioration in quality of compressions during 2 minutes of continuous chest compressions: a randomized manikin study investigating performance with and without feedback.

Citation: Scandinavian Journal of Trauma, Resuscitation & Emergency Medicine, 2012, vol./is. 20/(16), 1757-7241;1757-7241 (2012) Author(s): Lyngeraa TS, Hjortrup PB, Wulff NB, Aagaard T, Lippert A

Abstract: The study aims to investigate the effect of feedback on quality of chest compression with the hypothesis that feedback delays deterioration of quality of compressions.

Full Text: Available in fulltext at BioMedCentral  Available in fulltext at National Library of Medicine


 

Title: Resuscitation feedback and targeted education improves quality of pre-hospital resuscitation in Scotland.

Citation: Resuscitation, January 2012, vol./is. 83/1(70-5), 0300-9572;1873-1570 (2012 Jan) Author(s): Lyon RM, Clarke S, Milligan D, Clegg GR

Abstract: This study aims to analyse the impact of targeted resuscitation feedback and training on quality of pre-hospital resuscitation.

Full Text: Available in fulltext at Elsevier; Note: You will need to register (free of charge) with Science Direct the first time you use it.


 

Title: How the newly introduced compression, airway, and breathing sequence affects the training in pediatric cardiopulmonary resuscitation.

Citation: American Journal of Emergency Medicine, February 2012, vol./is. 30/2(371-2), 0735-6757;1532-8171 (2012 Feb) Author(s): Lubrano R, Messi G, Elli M, Training Center PBLS SIMEUP

Full Text: Available in fulltext at MD Consult; Note: You will need to register (free of charge) with MD Consult the first time you use it.


 

Title: The development and assessment of an evaluation tool for pediatric resident competence in leading simulated pediatric resuscitations

Citation: Resuscitation, July 2012, vol./is. 83/7(887-893), 0300-9572;1873-1570 (July 2012) Author(s): Grant E.C., Grant V.J., Bhanji F., Duff J.P., Cheng A., Lockyer J.M.

Abstract: The purpose of this study was to create and evaluate a tool to measure all elements of pediatric resuscitation team leadership competence.

 

Full Text: Available in fulltext at Elsevier; Note: You will need to register (free of charge) with Science Direct the first time you use it.


 

Title: Evaluation of ventilatory rates and the benefits of an immediate feedback device with and without supplementary instruction on out-of-hospital resuscitations

Citation: Academic Emergency Medicine, April 2012, vol./is. 19/(S261), 1069-6563 (April 2012) Author(s): Melia M.R., Handbury J.D., Janney J.

Abstract: This study measured ventilation rates of standard CPR (and pre-instruction on effects of hyperventilation) compared to CPR with the use of a commercial ventilation timer (and pre-instruction on effects of hyperventilation). The study also proposes that use of a ventilation timer, measuring and displaying to EMS providers real-time ventilations delivered, will have no difference in ventilation rates when comparing these groups.


 

Critical Care

The following sub-topics are covered:

  • Sepsis – the use of statins, biomarker MMP9
  • Acute lung injury (ALI)/adult respiratory distress syndrome (ARDS)
  • Use of non invasive ventilation (NIV) in weaning
  • Ventilator associate pneumonia (including E.Coli)

 

Title: Do aspirin and statins prevent severe sepsis?

Citation: Current Opinion in Infectious Diseases, June 2012, vol./is. 25/3(345-350), 0951-7375;1473-6527 (June 2012) Author(s): Sanchez M.A., Thomas C.B., O'Neal H.R.

Abstract: The article reviews the current literature regarding the use of aspirin and statins for the prevention of sepsis.


 

Title: Statins and outcomes in patients with bloodstream infection: a propensity-matched analysis.

Citation: Critical Care Medicine, April 2012, vol./is. 40/4(1064-71), 0090-3493;1530-0293 (2012 Apr) Author(s): Leung S, Pokharel R, Gong MN

Abstract: It was postulated that statins may be a good candidate as novel therapeutic agents for the treatment of sepsis. The study investigated whether ongoing statin therapy is associated with mortality in patients with bloodstream infection.

Full Text: Available in fulltext at Ovid


 

Title: Transfusion-related acute lung injury: a preventable syndrome?.

Citation: Expert Review of Hematology, February 2012, vol./is. 5/1(97-106), 1747-4094;1747-4094 (2012 Feb) Author(s): Muller MC, Juffermans NP

Abstract: In this review, the advantages and disadvantages of various preventive measures to prevent TRALI are discussed, related to both patient factors as well as blood component-processing strategies, including transfusion policy, donor management and practices of preparation and storage conditions of blood components.

Full Text: Available in fulltext at ProQuest

Title: A phase I study evaluating the pharmacokinetics, safety and tolerability of an antibody-based tissue factor antagonist in subjects with acute lung injury or acute respiratory distress syndrome.

Citation: BMC Pulmonary Medicine, 2012, vol./is. 12/(5), 1471-2466;1471-2466 (2012) Author(s): Morris PE, Steingrub JS, Huang BY, Tang S, Liu PM, Rhode PR, Wong HC

Abstract: This study was designed to determine the pharmacokinetic and safety profiles of ALT-836, an anti-TF antibody, in patients with ALI/ARDS.

Full Text: Available in fulltext at EBSCOhost Available in fulltext at BioMedCentral

Available in fulltext at National Library of Medicine Available in fulltext at ProQuest


 

Title: Preventive use of noninvasive ventilation after extubation: a prospective, multicenter randomized controlled trial.

Citation: Respiratory Care, February 2012, vol./is. 57/2(204-10), 0020-1324;0020-1324 (2012 Feb) Author(s): Su CL, Chiang LL, Yang SH, Lin HI, Cheng KC, Huang YC, Wu CP

Abstract: The effectiveness of noninvasive ventilation (NIV) after extubation in preventing post-extubation respiratory failure is still controversial. The authors conducted a prospective, multicenter randomized controlled study involving patients on mechanical ventilation for > 48 hours who tolerated a 2-hour spontaneous breathing trial and were subsequently extubated. The patients were randomized to NIV or standard medical therapy. Re-intubation rate within 72 hours was the primary outcome measure.


 

Title: Ventilator associated pneumonia.

Citation: BMJ, 2012, vol./is. 344/(e3325), 0959-535X;1756-1833 (2012) Author(s): Hunter JD

Full Text: Available in fulltext at Highwire Press


 

Title: Implications of endotracheal tube biofilm in ventilator-associated pneumonia response: A state of concept

Citation: Critical Care, May 2012, vol./is. 16/3, 1364-8535;1466-609X (23 May 2012) Author(s): Gil-Perotin S., Ramirez P., Marti V., Sahuquillo J.M., Gonzalez E., Calleja I., Menendez R., Bonastre J.

Abstract: The purpose of the study was to analyze the formation of ETT biofilm and its implication in the response and relapse of VAP.

Full Text: Available in selected fulltext at BioMedCentral


 

Title: Number needed to treat and cost-effectiveness in the prevention of ventilator-associated pneumonia

Citation: Critical Care, June 2012, vol./is. 16/3, 1364-8535;1466-609X (07 Jun 2012) Author(s): Wyncoll D., Camporota L.

Full Text: Available in selected fulltext at BioMedCentral


 

 

 

Title: Active surveillance cultures to predict ventilator-associated pneumonia resulting from methicillin-resistant Staphylococcus aureus: is there a role beyond search and destroy?.

Citation: Critical Care Medicine, May 2012, vol./is. 40/5(1651-2), 0090-3493;1530-0293 (2012 May) Author(s): Toschlog EA, Ramsey KM

Full Text: Available in fulltext at Ovid


 

Title: Active surveillance cultures of methicillin-resistant Staphylococcus aureus as a tool to predict methicillin-resistant S. aureus ventilator-associated pneumonia.

Citation: Critical Care Medicine, May 2012, vol./is. 40/5(1437-42), 0090-3493;1530-0293 (2012 May) Author(s): Chan JD, Dellit TH, Choudhuri JA, McNamara E, Melius EJ, Evans HL, Cuschieri J, Arbabi S, Lynch JB

Abstract: The authors sought to study the performance characteristics of once weekly active surveillance culture of methicillin-resistant S. aureus colonization in predicting the development of methicillin-resistant S. aureus ventilator-associated pneumonia.

Full Text: Available in fulltext at Ovid

Title: Comparison of ventilator-associated pneumonia (VAP) rates between different ICUs: Implications of a zero VAP rate.

Citation: Journal of Critical Care, February 2012, vol./is. 27/1(26-32), 0883-9441;1557-8615 (2012 Feb) Author(s): Sundar KM, Nielsen D, Sperry P

Abstract: This study was done to compare outcomes between two intensive care units (ICU) with one of them reporting a zero VAP rate.


 

Title: Ventilator-associated pneumonia is an important risk factor for mortality after major cardiac surgery.

Citation: Journal of Critical Care, February 2012, vol./is. 27/1(18-25), 0883-9441;1557-8615 (2012 Feb) Author(s): Tamayo E, Alvarez FJ, Martinez-Rafael B, Bustamante J, Bermejo-Martin JF, Fierro I, Eiros JM, Castrodeza J, Heredia M, Gomez-Herreras JI, Valladolid Sepsis Study Group

Abstract: The aim of the study was to analyze the impact of VAP on mortality excluding other comorbidities and to study its etiology and the risk factors for its development.


 

Title: Performance of the PIRO score for predicting mortality in patients with ventilator-associated pneumonia.

Citation: Anaesthesia & Intensive Care, March 2012, vol./is. 40/2(285-91), 0310-057X;0310-057X (2012 Mar) Author(s): Furtado GH, Wiskirchen DE, Kuti JL, Nicolau DP

Abstract: The aim of this study was to validate the PIRO score against the Acute Physiology and Chronic Health Evaluation (APACHE) II and VAP APACHE II in an independent group of VAP patients.


 

Title: Procalcitonin in early onset ventilator-associated pneumonia

Citation: Journal of Hospital Infection, June 2012, vol./is. 81/2(92-97), 0195-6701;1532-2939 (June 2012) Author(s): Zielinska-Borkowska U., Skirecki T., Zlotorowicz M., Czarnocka B.

Abstract: The aim was to assess the clinical usefulness of monitoring PCT concentrations in non-surgical patients with early onset VAP.

Full Text: Available in fulltext at Elsevier; Note: You will need to register (free of charge) with Science Direct the first time you use it.


 

Title: Eight initiatives that misleadingly lower ventilator-associated pneumonia rates

Citation: American Journal of Infection Control, June 2012, vol./is. 40/5(408-410), 0196-6553;1527-3296 (June 2012) Author(s): Klompas M.

Full Text: Available in print at Heartlands Staff Library


 

Title: Biomarkers in the diagnosis of ventilator-associated pneumonia

Citation: Current Respiratory Medicine Reviews, June 2012, vol./is. 8/3(184-192), 1573-398X;1875-6387 (June 2012) Author(s): Grover V., Soni N., Kelleher P., Singh S.

Abstract: This review highlights the markers that have gained the most attention to date and aims to discuss the challenges faced in introducing them at the bedside.


 

Title: Preventing ventilator-associated pneumonia - the role of the endotracheal tube

Citation: Current Respiratory Medicine Reviews, June 2012, vol./is. 8/3(170-183), 1573-398X;1875-6387 (June 2012) Author(s): Young P.J., Doyle A.J.

Abstract: This review appraises the role of the endotracheal tube in both the development and prevention of VAP.


 

Title: Treatment failure in ventilator associated pneumonia

Citation: Current Respiratory Medicine Reviews, June 2012, vol./is. 8/3(239-244), 1573-398X;1875-6387 (June 2012) Author(s): Iannella H.A., Luna C.M.


 

Title: The oral cavity, biofilms and ventilator-associated pneumonia

Citation: Current Respiratory Medicine Reviews, June 2012, vol./is. 8/3(163-169), 1573-398X;1875-6387 (June 2012) Author(s): Williams D.W., Lewis M.A.O., Marino P.J., Wise M.P.

Abstract: Recent studies have indeed highlighted that poor oral hygiene is a risk factor for VAP and therefore the maintenance of adequate oral health care in ventilated patients represents an important preventative strategy.


 

Title: The adequacy of timely empiric antibiotic therapy for ventilator-associated pneumonia: An important determinant of outcome

Citation: Journal of Critical Care, June 2012, vol./is. 27/3(322.e7-322.e14), 0883-9441;1557-8615 (June 2012) Author(s): Muscedere J.G., Shorr A.F., Jiang X., Day A., Heyland D.K.

Abstract: The individual impact of timeliness vs adequacy of empiric antibiotic therapy for a clinical suspicion of ventilator-associated pneumonia (CSVAP) is unknown. Accordingly, in patients with CSVAP and timely initiation of empiric antibiotic therapy, the study determined the impact of inadequate therapy (IT).


 

Title: Ventilator-associated pneumonia and ICU mortality in severe ARDS patients ventilated according to a lung-protective strategy

Citation: Critical Care, April 2012, vol./is. 16/2, 1364-8535;1466-609X (18 Apr 2012)

Author(s): Forel J.-M., Voillet F., Pulina D., Gacouin A., Perrin G., Barrau K., Jaber S., Arnal J.-M., Fathallah M., Auquier P., Roch A., Azoulay E., Papazian L.

Abstract: We aimed to determine the incidence, outcome, and risk factors of bacterial VAP complicating severe ARDS in patients ventilated by using a strictly standardized lung-protective strategy.

Full Text: Available in selected fulltext at BioMedCentral


 

 

 

 

 

 

 

 

 

 

 

 

 

 

Further Information:

The following sources have been scanned for evidence published in the previous 8 weeks: Lancet, BMJ, JAMA, NEJM and American Journal of Critical Care Medicine; and articles from other journals as retrieved via searches on MEDLINE and EMBASE are also listed.

For a detailed list of sources that have been scanned, please contact [email protected]

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